Bleeding from your vagina or uterus other than your normal menstrual cycle is considered abnormal and should be checked by your doctor. This includes unusually heavy bleeding with your period, spotting between periods, severe pain during your period, and bleeding past the date your period should stop. If you’re reached menopause and no longer have menstrual periods, any bleeding is abnormal.
If you’re younger than 20 or older than 40, you’re at higher risk for abnormal bleeding because hormone imbalances are common at the beginning and end of your reproductive life. Other causes of bleeding include
• infections in the uterus
In teenagers and young women; pregnancy can cause abnormal bleeding. Factors that can increase your risk of abnormal bleeding include
• excessive exercising
When Should I See My Doctor?
See your doctor if you’re
• passing blood clots the size of a golf ball or larger
• soaking a pad or tampon every hour
• feeling dizzy, weak, or feverish
• if you have severe abdominal pain
• your period doesn’t stop when expected
Be sure to tell your doctor if you could be pregnant.
How Will My Doctor Find Out What’s Wrong?
Your doctor will take a detailed medical history—which is your story of the problem and how long you have had it—and perform a physical exam. She’ll want to know if your periods are regular, the dates of recent periods, how long your periods last, and how heavy the blood flow is when your periods were “normal.” Your doctor ask how many times you’ve been pregnant and given birth, whether you’ve ever had an abortion or miscarriage, and if you use any type of birth control. She’ll also ask about any medicines including over-the-counter medicine and if you use recreational drugs.
Your doctor will do a pelvic exam to check problems with your vagina or cervix, such as an infection. She may also do a Pap lest. She’ll do an ultrasound exam to evaluate your uterus and ovaries. If you’re over 35, she may do an endometrial biopsy; where a small piece of the uterine lining is removed and examined under a microscope. Your doctor may
• take blood for a complete blood cell count
• order a thyroid function study (from the blood taken)
• take urine sample to check for infection
• do a pregnancy test
What Can Be Done To Fix The Problem?
Treating your problem will depend on the cause of the bleeding. If your blood count and blood pressure are normal, your doctor may start you on a birth control pill to help balance your hormones and make your periods more normal. If you have high blood pressure or can’t take estrogen, your doctor may prescribe progesterone instead.
You can take ibuprofen or naproxen for cramps unless your doctor tells you not to. Don’t take aspirin, which can make you bleed more. If your bleeding is very heavy, your blood count or blood pressure is low, and you’re having symptoms such as dizziness, you may need to go to the emergency room at your hospital.
If medicine doesn’t work, you may need a hysteroscopy to examine the uterus to look for the cause of the bleeding. Or your doctor may do an endometrial ablation, which involves inserting a heating device through your vagina into your uterus through your vagina and applying heat to destroy some of the lining of the uterus. Ablation is only done if you don’t want to have more children.
If medicine and endometrial ablation don’t stop the excessive bleeding, you may need surgery to remove your uterus, called hysterectomy.